[Risk factors of post-ERCP complications: a single-center retrospective study].

Area of Science:

• Gastroenterology and Hepatology
• Interventional Endoscopy
• Patient Safety

Context:

• Endoscopic Retrograde Cholangiopancreatography (ERCP) is a crucial procedure for diagnosing and treating biliary and pancreatic disorders.
• Post-ERCP adverse events, such as pancreatitis and cholangitis, remain a significant concern, impacting patient outcomes and healthcare costs.
• Identifying modifiable and non-modifiable risk factors is essential for improving ERCP safety and efficacy.

Purpose:

• To systematically analyze both individual and combined risk factors associated with early adverse events following ERCP.
• To identify novel predictors and quantify the synergistic effects of various factors on specific post-ERCP complications.
• To provide evidence-based insights for risk stratification and mitigation strategies in ERCP procedures.

Summary:

• A retrospective analysis of 876 patients undergoing ERCP for choledocholithiasis identified hyperamylasemia, pancreatitis, cholangitis, and cholecystitis as common complications.
• Procedural factors like double-wire cannulation, endoscopic papillosphincterotomy, and pancreatic stenting significantly increased the risk of pancreatitis and hyperamylasemia.
• Novel predictors for cholangitis (e.g., lithotripsy, sludge, age) and cholecystitis (e.g., stone size) were identified, along with the synergistic impact of combined factors on complications.

Impact:

• The findings highlight specific procedural elements and patient characteristics that predict ERCP-related complications, enabling targeted interventions.
• This research contributes to a better understanding of the multifactorial nature of post-ERCP adverse events, including previously unrecognized synergistic effects.
• Implementation of these identified risk factors into clinical practice can guide procedural modifications and patient management to minimize complication rates and enhance ERCP safety.